基于反相液相色谱的人血中茶碱浓度临床检测与分析

目的：建立快速、简便、准确、重现性好的人血中茶碱的测定方法。方法：采用HypersilODSCls（4．6mm×250mm,5μm）为色谱柱,流动相为甲醇-水（25：75）,内标物为咖啡因,检测波长为274nm,血清用甲醇沉淀蛋白后进行分析。结果：茶碱标准曲线回归方程为Y=0．0539X＋0．038,r=0．9994（n=8）,1-40斗咖l浓度范围线性关系良好。对36例患者作血清茶碱浓度监测,临床效果良好。结论：本测定方法为临床药师指导临床有效、安全的个体化药物的使用提供了保障。     

反相高效液相色谱法同时测定血清中多索茶碱和茶碱的浓度

目的：建立同时测定人血清中茶碱和多索茶碱浓度的反相高效液相色谱方法。方法：采用内标法,咖啡因为内标,分析柱为WondaSilCl8,流动相为甲醇-水-三乙胺-冰醋酸（35：65：0.01：0.01）,流速为1.0mL/min,柱温：30℃,检测波长为273nm;血清样品经12%高氯酸直接沉淀蛋白离心后取样进行色谱分析。结果：样品与内标的峰面积比（R）同样品浓度（C）间线性均良好,线性范围均在2.5-40mg/L,回归方程分别为：茶碱C=3.746R＋0.4436,r=0.9997,多索茶碱C=10.24R-4.506,r=0.9999;平均回收率为：茶碱99.89%（RSD=1.07%,n=5）,多索茶碱99.60%（RSD=0.81%,n=5）。结论：该方法简单方便,快速,准确     

反相高效液相色谱法测定血清中甲硝唑浓度

用反相高效液相色谱法测定血清中甲硝唑浓度，其操作要点是：样品血清２００μｌ内加入内标工作液及ｐＨ７．５磷酸盐缓冲液后，用３ｍｌ含５％异丙醇的氯仿提取。采用ＹＷＧ－Ｃ１８Ｈ３７分析柱，以甲醇：水（２７：７３）为流动相，茶碱作内标，在２５４ｎｍ波长下监测洗提液，按内标法定量。本法具有快速、简便、灵敏、准确等特点，适合于甲硝唑血药浓度测定及药代动力学研究用。     

反相高效液相色谱法测定血清中甲硝唑浓度

用反相高效液相色谱法测定血清中甲硝唑浓度。其操作要点是：样品血清２００μｌ内加入内标工作液及ｐＨ７．５磷酸盐缓冲液后，用３ｍｌ含５％异丙醇的氯仿提取。采用ＹＷＧ－Ｃ１８Ｈ３７分析柱，以甲醇：水（２７：７３）为流动相，茶碱作内标，在２５４ｎｍ波长下监测洗提液，按内标法定量。本法具有快速、简便、灵敏、准确等特点，适合于甲硝唑血药浓度测定及药代动力学研究用。     

高效液相色谱法测定苯妥英钠血药浓度

目的：建立测定血清中苯妥英钠浓度的高效液相色谱法。方法：以HypersilC。8柱（4．6mm×200mm,10μm）为色谱柱,流动相为甲醇一水（50：50）,流速为0．8ml／min,检测波长为230nm,血清样品加入3μl硫酸溶液（6M）混匀后用重蒸乙醚提取。结果：苯妥英钠血清样品线性范围为2．00-150．00mg／L,低、中、高三种不同浓度（8．33、33．33、100．00mg／L）加样回收率分别为98．40％、95．50％、102．71％,日内、日间RSD均小于5％。结论：本方法准确性好,灵敏度高,操作简便,可满足苯妥英钠血药浓度监测要求。     

RP-HPLC法测定人血清中地高辛浓度

目的建立测定人血清中地高辛浓度测定的方法。方法将血清酸化,用丙醇∶氯仿（1∶5）萃取2次,吹干萃取液,残渣用流动相溶解,采用高效液相色谱法测定,色谱柱：Hypersil ODS C18柱（250 mm×4.0 mm,5μm）,流动相：甲醇∶水（60∶40）,检测波长：220 nm。结果地高辛浓度在0.35~2.35 ng/mL范围内,地高辛和内标的峰面积比与浓度呈现良好线性关系（r=0.995 8）,平均回收率103.2%~106.4%,日内和日间精密度RSD〈7.5%（n=5）。结论该方法快速、简便、准确,适合于临床血药浓度监测。     

RP-HPLC法测定人血清中水杨酸的浓度

目的：建立测定人血清中水杨酸浓度的方法。方法：采用反相高效液相色谱法，HYPERSIL ODS（200×4．6mm，5μl）色谱柱；流动相：甲醇：1％乙酸（45：55）；流速：0．9ml／min；检测波长：299nm；柱温：35℃。结果：水杨酸在0．51-32．64μg／ml范围内有良好的线性关系，r=0．9999，血清中药物最低检测浓度为0．1μg／ml（S／N=3），提取回收率为90％，血清中三种浓度回收率分别为103．92％、99．68％、99．51％，日内、日间RSD分别为3．9％、1．6％、1．0％及5．9％、3．2％、1．9％。结论：本法操作简单、快捷，方法灵敏度和准确度较高，适用于血药浓度及生物利用度的测定。     

茶碱血清浓度测定（HPLC）法的改进

目的 :改进血清中茶碱浓度的 HPL C测定方法。方法 :血清经处理后 ,采用日本岛津 Shim- pack VP- ODS(2 5 0 L×4 .6 )柱 ,国产 C1 8保护柱 ,流动相为甲醇 -水 -三乙胺 -冰醋酸 (2 0∶ 6 0∶ 0 .4∶ 0 .3) ,检测波长 2 5 4 nm。结果 :茶碱浓度在3.4～ 4 0 .8μg/ ml呈现良好的线性关系 ;高中低 3种浓度的日内 RSD(n=5 )分别为 2 .35 % ,1 .4 1 % ,2 .6 1 % ,日间 RSD(n=5 )分别为 3.97% ,1 .87% ,2 .2 4 %。萃取平均回收率为 74 .6 4 % ,方法回收率平均为 99.2 6 %。结论 :本方法灵敏度高 ,操作简便易行 ,结果准确可靠 ,能满足茶碱血药浓度的测定     

老年慢性阻塞性肺病患者静脉血和唾液茶碱浓度相关性研究

目的 探讨茶碱在老年慢性阻塞性肺病（COPD）患者静脉血和唾液中浓度的相关性。方法 采用化学发光免疫分析法同时测定静脉滴注氨茶碱注射剂患者,给药前（0h）及开始给药后0．5h、1．5h、5h、8h、12h静脉血和唾液的茶碱浓度,并分析其相关性。结果 患者静脉血和唾液茶碱浓度相关性好（r=0．86）,经统计学分析,呈显著性相关（P〈0．05）;唾液茶碱浓度达峰时间迟于静脉血,给药后5h开始唾液茶碱浓度与静脉血茶碱浓度测定结果无显著性差异（P〉0．05）。结论 用唾液代替静脉血测定茶碱浓度,减轻了患者的病苦,节约了医疗劳动,有利于临床上广泛开展茶碱药物浓度的监测。     

RP—HPLC法测定人血浆中头孢拉定的浓度

目的：建立测定血浆中头孢拉定浓度的高效液相色谱法。方法：色谱柱为DiamonsilC18柱（200mm×4．6mm，5μm）；流动相：0．05mol／LKH2PO4-乙腈（85：15）；柱温：35℃；流速：1．0ml／min；检测波长：262nm；进样量：20μl。结果：头孢拉定在0．5-40．0μg／ml范围内有良好的线性关系，r=0．9999；血浆中药物最低检测浓度为0．25μg/ml（S／N=3）：提取回收率为75％；血浆中三种浓度回收率分别为（106．0±6．3）％、（103．0±4．6）％、（97．5±1．2）％，日内、日间RSD分别为419％-26％、1．0％及7．9％、3．2％、1．9％。结论：本法操作简单、快捷、专属性强，方法灵敏度和准确度均较高，适用于头孢拉定血药浓度及生物利用度的测定。     

APPLICATION OF LORNOXICAM TO PATIENT-CONTROLLED ANALGESIA IN PATIENTS UNDERGOING ABDOMINAL SURGERIES

FOR anesthesiologis s ,treatingpostoperativepainhas alwaysbeen a problem.Althoughopioidshave been provedtobe effective,theirsideeffectscouldnotbeignored.With thedevelopmentofscienceand pharmacology,many drugs with aspectsof satisfactoryanalgesicefficacyand couldbe welltoleratedby patientshave been developed.And lornoxicamisone of them, which isa non-steroidalanti-inflammatorydrug (NSAID ), with analgesic, anti-infl-ammatory,andantipyreticproperties.Itseliminationhalf-time(3 to 5 hours) isle…     

Dr.Zhang Ren''''s Experience in the Acupuncture Treatment of Different Diseases with the Same Therapeutic Principle

Dr.Zhang Ren,the chief physician,is the chairman of Shanghai Acupuncture and Moxibustion Association.Having been engaged in medicine for about 40 years,he is experienced in treating various intractable diseases.In his long years of clinical practice,he advocates taking the TCM differentiation as the basis to seek for the acupuncture method for treatment of modern intractable diseases.The author of this essay had the fortune to follow Dr.Zhang in study.The following is a summary of Dr.Zhang's experience in the acupuncture treatment for different intractable diseases with the same therapeutic principle.     

Luo Lingjie''''s Experience in Treating Chronic Nephropathy

In treating chronic nephropathy,Luo Lingjie,a chief physician,pays attention to regulating the balance between yin and yang,treating infection if present,and removing pathogenic factors.He prescribes gentle drugs and uses carefully strongly warming-tonifying ones,emphasizes the importance of persuading the patient to persist in treatment with medication and nurse one's health for recuperation,and is good at combined use of TCM and western medicine therapy and brings the merits of various therapies into full play,with obvious theraoeutic effects.     

Acupuncture Combined with Spinal Tui Na for Treatment of Primary Dysmenorrhea in 30 Cases

Objective: To observe the therapeutic effects in acupunture treatment of primary dysmenorrhea combined with spinal Tui Na, and study its mechanism. Methods: Thirty cases of the treatment group were treated by acupuncture combined with spinal Tui Na, and thirty cases in the control group were treated by routine acupuncture. Results: The total effective rate was 93.3% in the treatment group, and 73.3% in the control group, with a significant difference between the two groups (P<0.05). Conclusions: Acupuncture combined with spinal Tui Na has good prospects for treatment of primary dysmenorrhea.     

猪肺磷脂注射液联合经鼻持续气道正压通气对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性的影响

目的 探讨猪肺磷脂注射液联合经鼻持续气道正压通气(NCPAP)对呼吸衰竭早产儿的临床疗效及肌酸激酶同工酶活性(CK-MB)的影响.方法 选取呼吸衰竭早产儿80例,分为观察组和对照组各40例.对照组采用NCPAP给氧治疗,观察组给予NCPAP给氧联合猪肺磷脂气管内给药.观察两组患儿治疗前及治疗12h、24 h后PaO2、PaCO2、血氧饱和度(SaO2)、pH的变化情况,检测治疗前及治疗5d后血清CK-MB水平;评估两组患儿的临床治疗效果.结果 两组患儿PaO2、PaCO2、SaO2、pH比较,差异均有统计学意义(P＜0.05),其中观察组治疗后的PaO2、SaO2、pH均高于对照组,PaCO2则低于对照组.两组的PaO2、SaO2、pH均随观察时间延长而升高(P＜0.05),PaCO2均随观察时间的延长而降低(P＜0.05).观察组治疗有效率为87.5％,显著高于对照组的70.0％ (P ＜0.05).治疗5d后两组患儿血清CK-MB水平均较前降低(P＜0.05),且观察组明显低于对照组(P＜0.05).结论 猪肺磷脂注射液气管内给药联合NCPAP可以显著降低呼吸衰竭早产儿CK-MB的含量,提高治疗有效率,起到很好的呼吸循环支持作用.     

Survey and practice of reporting quality of randomized controlled clinical trials on traditional Chinese medicine

Evidence obtained from randomized controlled trials （RCTs） has been generally accepted as the gold standard in the evaluation of clinical effectiveness. Readers need to understand the trial design, implementation, results, analysis and interpretation, so as to fully Jnderstand the results of RCTs. Thus, the investigators of RCTs have to report these items in a complete, accurate and clear manner. Since 1998, we have conducted several evaluations on the reporting quality of RCTs published in Chinese journals on traditional Chinese medicine （TCM） and results have shown that there is an urgent need for higher quality RCTs on TCM.     

TCM Treatment of Ankylosing Spondylitis by Tonifying the Kidney and Strengthening the Governor Vessel

Ankylosing spondylitis is a chronic and progressive disorder with inflammation mainly involving the central axis joints. It mainly affects the cervical spine and the lumbosacral area, with the pathogenesis closely related to the kidney and the Governor Vessel (GV). TCM holds that the syndrome is deficiency in origin and excess in superficiality, which is due to insufficiency of the kidney, deficiency of GV, and blocking of the channels with the invasion of exogenous evil, leading to poor circulation of qi and blood and malnutrition of the bones, muscles and joints. The TCM method of tonifying the kidney and strengthening GV to regulate circulation of qi and blood and check the arthralgia pain should be adopted, with the Kidney-Tonifying and GV Strengthening Decoction (益肾强督汤) prescribed.     

IMPROVING P-gp EXPRESSION IN HUMAN MONONUCLEAR CELLS IN VITRO TRANSFECTED BY MULTIDRUG RESISTANCE-1 mRNA

CHEMOTHERAPY playsa greatrolein the treat- ment of malignanttumors,especiallyingynecolo- gicalones.But inanticancerchemotherapy,leuko-cytopeniaisfrequentlytheprimarydose-limitingsideeffect factor.Moreover,cancersarefrequentlychemoresistantbe-causeof overexpressionof P-glycoprotein(P-gp), which isencodedby multidrugresistancegene (MDR1 ) and detectableinup to50% ofhuman cancersand renderscellsresistancetoanticancerdrugs.The safetyand potentialtherapeuticbenefitof mdr1 gene transferredto h…